New ACA Preventive Service Coverage Requirement for HIV (PrEP)

The U.S. Preventive Services Task Force has issued a new recommendation that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.

The U.S. Preventive Services Task Force (USPSTF) has issued a new recommended preventive service:

The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.

Non-grandfathered group health plans must cover this service, without cost-sharing, i.e., no copay, coinsurance, or deductible, effective for plan years beginning on or after June 11, 2020 (January 1, 2021 for calendar year plans).

The ACA requires that non-grandfathered group health plans cover, without cost-sharing, all preventive services with an A or B rating from the USPSTF.

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